No BP taken before BP meds??

[brandinalove]

At my facility the process is to take a resident's BP prior to administration of their anti-hypertensives x 7 days when they're first admitted. If the 7 days show they have normal or high BP ranges then it goes to a weekly BP check and the nurses are no longer required to take their BP before administering scheduled BP meds. Just wondering if this is the policy at any other facility. The reason I can't comply with the policy is I'm convinced that the one time that I don't take someone's BP before medicating them that their BP will already be low and they'll bottom out.

[Blackcat99]

We were told that we are required to check all B/P's on all patients receiving hypertension meds only when the state inspector is doing your med pass with you.

[montecarlo64, ASN, BSN, LPN]

Since I float around & don't get to know the residents norms, I always check their BP & HR even if there is no order or a hold parameter. Every once in a while I get a very low reading & then I call the physician. I just feel more comfortable doing it this way since so many of them are on multiples.

[CapeCodMermaid, RN]

We were told that we are required to check all B/P's on all patients receiving hypertension meds only when the state inspector is doing your med pass with you.

That is really not a good practice. If you do things the right way every day, when the DPH is there, it won't be so nerve jangling.

[Blackcat99]

I was told that the most important thing at my job is to clock out on time. They hate it when nurses do overtime.

[Vinniesguy]

If I had to have taken the BP of every one of my residents (which was about all 30 of them) morning rounds would take all day!

I can see the point of seven days but if they've been taking them for years trying to withhold it will probably cause you, and them so much grief their blood pressure would shoot up anyway!

[VANurse2010]

That is really not a good practice. If you do things the right way every day, when the DPH is there, it won't be so nerve jangling.

Except checking every day before every med admin. isn't the right way to do things in this context.

[CapeCodMermaid, RN]

I didn't say it was. I was commenting on the post that said they only do it when the state is there.

[AngelRN27]

My facility also uses the "Hold if BP less than 110/60" parameter, and we must therefore take a BP before any BP med admin. I usually have 24 patients and usually finish all med passes on time lol

[VANurse2010]

In my opinion, having parameters like that in LTC is not appropriate. If they are unstable enough to need it checked daily, then they probably shouldn't be in LTC. Also, 24 is a pretty light load in LTC.

[paullissa]

I usually have to check their pulse before giving lopressor and there is a couple of residents now we have to take their BPs before giving the med. I think it's mandatory now per state regulation so we better get used to it.

[CapeCodMermaid, RN]

State can not override physician orders.

Many of what we think are state 'regulations' are company policies come about as a result of a poor survey.